October 12, 2017

Can’t Even Cry: Experts Discuss the Mental Health of Syrian Refugee Children

Clinicians, nonprofit leaders, academics, and national experts gathered at Georgetown for a conference on October 10 on the heartbreaking mental health status of Syrian refugee children.

Syria has been in a state of war and political turbulence since 2011, displacing millions and forcing many to seek asylum outside the borders of their homeland. An estimated 5.1 million Syrians, including 2.4 million children, have become refugees in Egypt, Turkey, Lebanon, Jordan, and other countries.

“This is no sort of childhood to have, at any age, in any place,” remarked Huda Muasher, founder of Iman Early Learning Center, a pre-school in Jordan for children aged 2 to 4.

Sponsored by the Georgetown University Center for Child and Human Development, the Walsh School of Foreign Service, and the Global Health Initiative, “Syrian Refugee Children: Assessing and Addressing Developmental and Mental Health Issues,” explored the state of the crisis as well as potential solutions to the mental health problems faced by the children.

‘Toxic Stress’

Through a series of individual presentations, speakers described the trauma experienced by young children as a result of the crisis, including damaged cognitive function and psychological disorders such as PTSD, anxiety, and depression.

“These children are in complete shock, they don’t interact, they don’t show emotion, they can’t even cry,” said Dr. M. Zaher Sahloul, a senior advisor and former president of the Syrian American Medical Society.

Alexandra Chen, a mental health specialist and advisor to U.N. agencies on the Syrian crisis, emphasized the source of “toxic stress” – or chronic trauma – faced by refugee children. 

“The idea is that as refugees, the trauma for these children is in the past, that they are doing better somehow,” she said. “But the reality is, when you're living homeless, rightless, dignity-less, and documentless in a country that doesn't want you and is more likely to abuse you, that is what we called toxic stress.”

Unique Challenges

Speakers explained the difficulty of recognizing and properly addressing the psychological consequences that war and displacement have on young children. Cultural stigmatization of mental health issues, as well as failure to target children of all ages in solution models, hinder the ability of professionals to help refugee children.

Those with disabilities also face distinctive challenges, and their numbers are growing. Dr. Rachel Brady, an assistant professor in the Department of Pediatrics and director of information dissemination at Georgetown’s Center for Child and Human Development, explained that almost a quarter of Syrians have some type of disability as a result of the crisis.

Muasher reiterated the disproportionate vulnerability and insufficient attention given to young children and children with disabilities. 

“Children aged 0 to 5 and children with disabilities are the most vulnerable victims in emergencies and need the most assistance, but they are consistently targeted the least in humanitarian efforts,” she said.

The Next Generation

The conference concluded with an exploration of potential solutions that may facilitate the process of helping refugee children, including a suggestion from Brady about a model that focuses on family and community structures.

"Models such as the community-based rehabilitation model are family-centered and therefore culturally and linguistically competent,” she described. “They promote participation in the natural environment.”

Sahloul emphasized the stakes of addressing the mental health of refugee children now. “This next generation will rebuild Syria, and unless we take care of their mental health, we will have a problem in the rebuilding process,” he said.

Dr. Phyllis Magrab, a professor in the Department of Pediatrics and director of Georgetown’s Center for Child and Human Development, said Georgetown’s Jesuit values are in keeping with mobilizing greater action to help Syrian refugee children.

“This is a real opportunity for us to act on the value of men and women for others and help those who are most in need,” she said.